Customers purchasing health care related goods or services may be covered by a primary insurance plan and by health care reimbursement plans, such as self-funded flexible spending accounts (FSA), health care spending accounts (HSA), or health care reimbursement accounts (HRA). The health care reimbursement plans may cover expenses not otherwise covered by the primary insurance plan, such as costs for co-payments, prescription drugs, and some over-the-counter medications and health care products.
Under some health care reimbursement plans, the patient pays out of pocket for the health care related purchase, and the patient or his/her employer submits a claim to the health care reimbursement plan administrator requesting reimbursement for the purchase. These reimbursement claims require the patient to provide sufficient information to the health care reimbursement plan administrator to allow the health care reimbursement plan administrator to verify that the purchase qualifies as a valid purchase under the health care reimbursement plan, which is generally referred to as substantiating the claim.
In an effort to improve upon this process, other health care reimbursement plans and/or the patient's employer have issued payment cards (e.g., debit or credit cards) to the patient that are linked to the patient's health care reimbursement plan account and are usable by the patient to pay for health care related expenses. However, this arrangement may have disadvantages, such as difficulty in providing substantiation information for the payment due to the limited number of data fields available over the banking networks used by credit and debit cards which may result in the need for the patient or patient's employer to submit substantiation documentation after the purchase, high costs associated with setting up a system that accepts these types of cards (e.g., new point-of-sale devices or software to communicate over the banking networks), and high fees payable by the health care provider for using the banking networks.
Providing documentation to the administrator may require patients or health care providers to physically mail the documentation to the plan administrator. Thus, significant delays may result before patients receive reimbursement, which may dissuade patients from participating in the health care reimbursement plan.
Thus, a need in the art exists for an arrangement that allows payment for eligible purchases at the point of sale from the health care reimbursement plan and provides sufficient substantiating documentation to health care reimbursement plan administrators to avoid unduly burdening customers or their employers.